I think this is worth a look if you have campaigns that don't have long dungeon crawls. I run a sandbox style game with a lot more rests and breaks between events than most DMs. This book gives some options for longer term effects for players that get bloodied or knocked unconscious. It takes a bit of tweaking to keep it balanced and not cause a spiral into death. Who doesn't do that as a DM anyway? You have to bend the rules when it makes sense and keep it fun.
This is exactly what I want and expect for my two bucks. Clearly written and attractive, these optional rules would be a great addition to any 4e campaign suffering from overpowered adventurers as mine currently is.